Healthcare Provider Details

I. General information

NPI: 1013539360
Provider Name (Legal Business Name): DANIELLE LEVANAS MA, LCAT, RDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2020
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 SILVER RIDGE AVE
LOS ANGELES CA
90039-3646
US

IV. Provider business mailing address

2350 SILVER RIDGE AVE
LOS ANGELES CA
90039-3646
US

V. Phone/Fax

Practice location:
  • Phone: 646-271-4971
  • Fax:
Mailing address:
  • Phone: 646-271-4971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101200000X
TaxonomyDrama Therapist
License NumberLCAT002074
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCAT002074
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: